Seattle, King County move to open nation’s first safe injection sites for drug users

Originally published January 27, 2017 at 1:32 pm
Updated January 28, 2017 at 11:22 am

King County Executive Dow Constantine, left, and Mayor Ed Murray presented eight recommendations to focus on prevention, increasing access to treatment on demand and reducing the number of fatal overdoses. At right is King County public health officer Jeff Duchin, MD. Hidden behind Duchin is King County Sheriff John Urquhart. (Greg Gilbert/The Seattle Times)

Seattle and King County want to create two safe sites for people dealing with addiction to consume or inject drugs, the first of their kind in the country, Mayor Ed Murray and County Executive Dow Constantine announced. But no locations or funding have been identified yet.

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Seattle and King County will create two safe-consumption sites for drug users, the first of their kind in the country, as part of an effort to halt the surge of heroin and prescription opioid overdose deaths in the region, Mayor Ed Murray and County Executive Dow Constantine announced Friday.

The sites, stocked with the overdose-reversing drug naloxone, aim to save lives and connect people dealing with addiction to treatment services.

Murray and Constantine said they will move forward with all the recommendations of the Heroin and Prescription Opiate Addiction Task Force that they convened last year, the most controversial of which are the safe drug-use sites.

Other recommendations include increasing access to naloxone and medication assisted treatment drugs like Suboxone.

“The crisis is growing beyond anything we have seen before,” Murray said. “We can do something about that.”

No locations or funding have been announced, but Murray said the first of the two sites will be in Seattle, and the second will be outside the city.

He also acknowledged that getting funding may be more difficult with the new presidential administration.

There are still big battles to come, as an “implementation work group,” chaired by Patty Hayes, the director of Public Health – Seattle and King County, tries to determine funding and locations for the sites, which are likely to spur protests from surrounding neighborhoods.

“These things have to exist, physically, somewhere,” said Daniel Malone, director of the Downtown Emergency Service Center, and a task force member. “There is significant trepidation about a location becoming an area that gets really damaged by having this particular activity happen there.”

Both Murray and Constantine were resolute that they could deal with any political blowback caused by the locations of the sites.

“Whatever our discomfort with this as elected officials, as a community, put yourself in the place of a parent who is trying to save his or her child,” Constantine said. “We can put up with a little discomfort in order to be able to help that family heal and help that child recover.”

Said Murray: “Our biggest challenge is ahead of us, making it operational.”

The sites aim to quell the flood of overdose deaths and to connect drug users with health care and long-term treatment. They also aim to move drug abuse off sidewalks and out of alleys.

More than 600 used needles were found in Seattle’s urban core in November, said Brad Finegood, a task force member with the county Department of Community and Human Services.

“People use drugs all throughout our country,” said Caleb Banta-Green, a public health professor at the University of Washington specializing in drug abuse, and a task force member. “People use in public; they don’t want to use in public, and the public doesn’t want them using in public.”

Although no such sites exist in the United States, Vancouver, B.C., has had one since 2003. Drug users come to get clean needles and inject in a safe, supervised environment. Naloxone is used multiple times a day and is credited with preventing nearly 5,000 overdoses at the site in Vancouver.

But the site has not stopped overdose deaths outside its walls. There were 914 overdose deaths in British Columbia, which has about double the population of King County, in 2016. That’s a record number, one largely driven by the rise of fentanyl, a powerful synthetic painkiller that is as much as 100 times more powerful than morphine.

Heroin overdoses killed 132 people in King County in 2015. The death toll rises to 209 when overdoses from prescription opioids — which are, molecularly, virtually identical to heroin — are included.

In the state Legislature, Sen. Mark Miloscia, R-Federal Way, has introduced legislation that would ban safe injection sites throughout the state.

“We must stop the push for decriminalization of drugs,” Miloscia said earlier this month. “Standing idly by while addicts abuse illegal drugs is not compassionate, and it does not solve the problem.”

Another potential complication: While local law enforcement is on board with the sites and Gov. Jay Inslee has said they are a local decision, the task force has not consulted with any federal agency to discuss a possible federal law-enforcement reaction.

Task-force members compared the consumption sites to needle-exchange programs, which the federal government initially opposed but nevertheless allowed localities to implement.

“This is an extension of our needle exchange. We’re treating this as a local issue and we’re using tools that we have,” said Dr. Jeff Duchin, the county public health officer and the task force’s co-chair. “We don’t routinely, and we haven’t in this case, consulted any other authority, and we don’t think we need to.”